Tracey P Grim, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

C1-0011097 Issued in DE

Practice address

100 Wellness Way
Milford, DE 19963-4364

Phone

(302) 422-3311

NPI assigned

Jul 6, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 11

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Designer Family Eyecare, LLC

  • Eyewear Supplier
  • York, PA
  • NPI 1487796421
  NPD (past)
• Penn Highlands Life'S Journey

  • Obstetrics & Gynecology Physician
  • Du Bois, PA
  • NPI 1558868570
  NPD (past)
• Wellspan Medical Group

  • Pediatric Surgery Physician
  • York, PA
  • NPI 1104799428
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680825600000",
    "number": "1447282116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 LOWNDES HILL RD BLDG 1",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296072101",
            "telephone_number": "800-967-2289",
            "fax_number": "855-621-7065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WELLNESS WAY",
            "city": "MILFORD",
            "state": "DE",
            "postal_code": "199634364",
            "telephone_number": "302-422-3311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIM",
        "first_name": "TRACEY",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2023-04-07",
        "certification_date": "2023-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PA",
            "license": "MD044957E",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "DE",
            "license": "C1-0011097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTHMERCY- WMG",
            "identifier": "1142786",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5272418",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON- WMG",
            "identifier": "80744",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS-WMG",
            "identifier": "02016202",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY- WMG",
            "identifier": "1506605",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI-ALLIANCE - WMG",
            "identifier": "348539",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST MD BCBS",
            "identifier": "524956",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001250840",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHNS HOPKINS",
            "identifier": "32662",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER HEALTH PLAN",
            "identifier": "39193",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "662061",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kizzie Green
• Katherine Greene
• Sharon Greenly
• Allison Griffith
• Nicole Griffith
• Kimberly Gross, NP
• Tyasia K Guadalupe, DO
• Stephanie Guadarrama, DO
• Amanda Maria Gunderson
• Preeti Gupta, M.D.

• Obstetrics & Gynecology Physician in Milford, DE
• Providers in Milford, DE by specialty
• Obstetrics & Gynecology Physician in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.